What sexual health psychiatry covers
Sexual health psychiatry addresses the emotional, cognitive and relational factors that affect sexual wellbeing. It includes low sexual desire, difficulty with arousal or orgasm, performance anxiety, pain during sex, distress about pornography or compulsive sexual behaviour, body image concerns, and sexual difficulties related to depression, anxiety, trauma or medication.
The assessment is respectful and non-judgemental. People often delay seeking help because of shame, fear of being judged or uncertainty about whether the problem is physical or psychological. Both are valid reasons to seek care, and the two often overlap.
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Common concerns
Low desire is one of the most common concerns and can be related to stress, relationship conflict, exhaustion, depression, hormonal change or medicine. Erectile difficulties and premature ejaculation often involve anxiety about performance, which then worsens the problem. Pain during sex needs a gynaecological or urological review alongside psychological assessment.
Compulsive sexual behaviour or distress about pornography use is approached as a pattern of behaviour that feels out of control and causes consequences, not as a moral failing. The assessment looks at triggers, function, shame, mood and coexisting conditions such as ADHD, anxiety or trauma.
| Concern | Factors to review |
|---|---|
| Low desire | Mood, stress, relationship, hormones, medicine, sleep |
| Performance anxiety | Anxiety cycle, expectations, previous experiences, alcohol use |
| Pain during sex | Gynaecological or urological cause, trauma, muscle tension, anxiety |
| Compulsive sexual behaviour | Triggers, shame, mood, impulse control, coexisting conditions |
Assessment and confidentiality
The first appointment takes a sexual and relationship history at a pace that feels manageable. You do not have to disclose anything you are not ready to discuss. The psychiatrist does not perform a genital examination; when a physical examination or test is needed, you are referred to the appropriate specialist.
Conversations are confidential within the limits explained at the start. A partner may be invited for part of the assessment if that is helpful, but only with consent. Treatment may include CBT, couple-focused work, medication review or coordination with urology, gynaecology, endocrinology or physiotherapy.
Access and booking
Appointments are at Mind Wellness Center, Durbar Marg area, Kathmandu. Call +977-9747736624 or use /book-appointment. Telepsychiatry is available for appropriate follow-up and for patients who cannot attend in person. This is not an emergency service; if there is immediate risk of harm, go to the nearest emergency department.